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U.S. Department of Veterans Affairs fax number
(833) 748-0256
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Bowel & Bladder Care Claims (VA Form 10-314)
Used for: Submit VA Form 10-314 (Request for Payment of Bowel and Bladder Services) by fax to 833-748-0256; alternate submission by mail to the Vancouver, WA Regional Payment Center at 1601 E Fourth Plain Blvd, Vancouver, WA 98661; claims must be submitted within 180 days of the date of service.
Fax destination details
- Department
- Bowel & Bladder Care Claims (VA Form 10-314)
- Purpose
- Submit VA Form 10-314 (Request for Payment of Bowel and Bladder Services) by fax to 833-748-0256; alternate submission by mail to the Vancouver, WA Regional Payment Center at 1601 E Fourth Plain Blvd, Vancouver, WA 98661; claims must be submitted within 180 days of the date of service.
- Form
- VA Form 10-314 — VA Form 10-314, Request for Payment of Bowel and Bladder Services
- Address
- 1601 E Fourth Plain Blvd, Vancouver, WA 98661
- Voice phone
- 877-881-7618
- Website
- Visit organization website
Before you send
- Confirm that this exact department handles your document or request.
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Fill VA Form 10-314 with Veteran's name and ICN, provider name and address, provider TIN/SSN, provider NPI, referral number, and the dates/durations of bowel/bladder care; sign and date; submit as instructed (the form is intended for use by individual B&B providers certified through the VA's Spinal Cord Injuries and Disorders Program). See page 2 for detailed instructions.
Official form instructions are published as a downloadable file on the organization's website.
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